Associate, Network Contracting

About the role

You will be responsible for managing contracts with key healthcare providers in Oscar's network (hospital/health systems and large national ancillary groups) to build and maintain a robust network; while also ensuring access to quality care and optimizing costs by analyzing provider performance and negotiating reimbursement rates, often involving complex contract terms and compliance with regulatory guidelines.

Responsibilities

• Implement contracting strategies under the direction of Network Director and/or Senior Manager and in partnership with Market Leaders that align with the company's overall network adequacy, development and cost management objectives.
• Manage and negotiate contracts with assigned healthcare providers, focusing on favorable terms and compliance with organizational standards and regulatory requirements.
• Support comprehensive reviews and analyses of assigned provider contracts, identifying areas for improvement and optimization.
• Utilize data and analytics of provider financial issues and competitor strategies to support informing negotiation and contracting decisions.
• Maintain defined metrics and Service Level Agreements (SLAs) including but not limited to provider outreach and contract completion.
• Collaborate with the provider services team regarding the servicing, education and communication to our provider network.
• Monitor assigned networks to gauge compliance with standards, developing corrective action plans with network contracting and market leadership to remediate deficiencies.
• Comply with all applicable laws and regulations.
• Other duties as assigned.

Requirements

• 3+ years of experience in healthcare client management, healthcare consulting, or provider healthcare contracting, healthcare operations, or a related field.
• 2+ years of experience supporting provider network strategy development and negotiating provider contracts.
• 1+ years experience running financial analyses on a markets or product lines, and working cross-functionally to support driving improvement opportunities.
• 1+ years experience navigating and organizing large data sets such as claim files and provider rosters.

Bonus Points

• Associate's degree or equivalent professional working experience.

Benefits

• Medical, dental, and vision benefits.
• 11 paid holidays.
• Paid sick time.
• Paid parental leave.
• 401(k) plan participation.
• Life and disability insurance.
• Paid wellness time and reimbursements.